title: [Clinical applicability of the framingham 30-year risk score. Usefulness in cardiovascular risk stratification and the diagnosis of carotid atherosclerotic plaque].
abstract: OBJECTIVE
  The traditional Framingham score underestimates cardiovascular risk in certain populations. Extending its time-scale to 30 years and assessing its relationship with the presence of carotid atherosclerotic plaque may improve risk stratification. The objectives were: a) to determine the percentage of patients previously classified with the traditional score who were reclassified when using Framingham 30-year risk score; b) to analyze the prevalence of carotid atherosclerotic plaque; and c) to determine the diagnostic potential of the 30-year score to detect carotid plaque.
  
  
  METHODS
  A carotid Doppler ultrasound study was performed and the Framingham 10-year risk score and 30-year score (based on lipids and body mass index) for "hard" cardiovascular events were calculated in a population of primary prevention patients. Prevalence of carotid plaque was determined. Receiver operating characteristic analysis was conducted.
  
  
  RESULTS
  In total, 305 subjects were included (age 48 [11] years, 52% men). The 30-year scores based on lipids and on body mass index reclassified 70% and 63% of the population, respectively. Prevalence of carotid plaque was 28.5% and associated gradually with risk category. The area under the curve and optimal cutoff points of the 30-year score to detect carotid plaque were 0.862 and 26% (based on lipids) and 0.845 and 22% (based on body mass index), respectively.
  
  
  CONCLUSIONS
  The 30-year score reclassified a large number of patients and discriminated between those with or without evidence of carotid plaque.
authors.affiliation: Servicio de Cardiología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. walter.masson@hospitalitaliano.org.ar
authors.forename: Walter
authors.initials: W
authors.lastname: Masson
authors.forename: Daniel
authors.initials: D
authors.lastname: Siniawski
authors.forename: Juan
authors.initials: J
authors.lastname: Krauss
authors.forename: Arturo
authors.initials: A
authors.lastname: Cagide
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002340:Carotid Artery Diseases / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006439:Hemodynamics; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000453:epidemiology*; D012372:ROC Curve; D018570:Risk Assessment; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents